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P��<MIT APPLICATIO�� <br />CI?'Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CAF.DS ARE NOT ACCEPTED <br />SITE ADDRESS <br />LOT <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />BLOCK TRACT <br />ADORESS <br />rv�a,U r�r,�na�crn.o-�-'— <br />I CONTACT. RPERMIT <br />�e- p V�-r o�l <br />=P 0 �I U. � l, /4 <br />ADDRESS <br />q PD �uX <br />�i� n <br />HEATSOURCE <br />Electric Gas Olher <br />PERMIT # <br />� <br />PHONE <br />u 2�i-�Igl-� l� (a �I <br />CITY2IP PHONE <br />II �,ur�.6(. � KU� 2 <br />I CONTRACTPRICEOFWORK <br />WORK DESCRIPTION - . <br />�� � .� G�� ��- �,���c.� �� <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/Car/mop/etc.) <br />Backflow preven!er <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />i� <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS <br />k <br />I hereby ceritify lhat i have read and examined this application and know lhe same to�We ard corrert. All provisions of laws and <br />ordinaces governing lhis type of work will be complied with whelher specified herein or not. The granting of a permit does nol presume <br />to give aulhority to violale or cancel the provision of any other state or local law regulaling constructlon or the performance of <br />construction. That I am aulhorized by lhe owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 1827 RCW and 296200 WAC. <br />